Can't We Do Better on Suicide Prevention in Prison?

Suicides have gone down since "safety smocks" came to prison, but there might be other ways to reduce self-harm in Segregation Units.

As college classes start back up in earnest, I’m planning yet another field trip to take my students to prison. Students want to see the reality of incarceration—not just what’s on TV—so they often ask to see the grim, grey isolation area. Usually this area—which prisoners call “The Hole” but is formally called “Segregation” or “Seg”—is off-limits to visitors. It’s where prisoners are separated from the general population and held in a small, barren cell with a cot and a toilet, 23 out of 24 hours, with one hour of recreation a day.

Seg units have become controversial as solitary confinement is starting to get a hard look. Solitary confinement was recently called “cruel and unusual punishment” by Sen. James Eldridge (D-Acton), who along with Rep. Elizabeth Malia (D-Boston), filed a bill this month to put more restrictions on the use of solitary confinement in Massachusetts prisons.

Here’s a little-known fact about prison Segregation Units: Besides housing those in protective custody (such as sex offenders who need protection from the general population) or those locked for disciplinary problems, some prisoners are isolated because they are suicidal. At some prisons and houses of corrections across Massachusetts, those at risk for suicide no longer wear prison jumpsuits, but instead wear what are known in the trade as “anti-suicide smocks”—a tunic that weighs 4 1/2 pounds and is so thick it’s advertised as noose-proof.

In case you’ve never had the opportunity to see an anti-suicide smock, this is a visual of what we’re talking about:

Billerica House of Correction bought smocks after a rash of eight prison suicides in Massachusetts in 2010. According to the Middlesex Sheriff’s Office, Billerica had 11 suicide attempts that year, and after The Boston Globe reported that, in 2010, Massachusetts prison suicides were four times the national average, re-evaluation and re-training occurred in facilities throughout the state. Also adding fuel to the fire was a study in 2007 by the Justice Department finding that “64 percent of inmates across the country reported mental health problems within the past year.” That meant more and more facilities were housing troubled—and not just dangerous—people. In 2013, two years since Billerica instituted the smocks, the suicide rate dropped to zero.

Depending on whom you ask, anti-suicide smocks are common practice across the country. Ferguson Safety Products, the creator of the smock pictured above, says on its website that more than 1,000 prisons in the U.S. use them. Ferguson makes anti-suicide mattresses and even has a sanitary belt developed specifically for suicidal females that “produces a gagging reflex if an inmate attempts to choke herself.” The smocks cost $250 each, and that’s probably a lot less expensive than having a prisoner on mental health watch under constant supervision.

The smocks, pun intended, seem like overkill. The American Civil Liberties Union has serious concerns about isolation tools. The group says that in the U.S., “individuals are sent to prison as punishment not for punishment” and that just the act of being alone in a cell 23 out of 24 hours can add to suicidal thoughts. Beyond that, imagine what it would feel like to wear an anti-suicide smock: The humiliation of being barefoot, without underwear and, worse, to also sleep without sheets on an anti-suicide mattress as long as a prisoner is deemed at risk.

If there is another way, maybe it’s along the lines of what’s being done at the Hampden County Correctional Center (HCCC), a House of Correction that serves Springfield, Chicopee, and Holyoke. HCCC has had zero suicides in the past 20 years. Spokesperson Rich McCarthy says HCCC has gone in another direction in their Seg Unit. Their website discusses how the facility aims to “counter the mental deterioration that can take place in lockdown” by a number of behavioral “carrots” including offering “in-cell programming for one hour, twice a week, through the use of an MP3 Headset System.” Similar to electronic books, the Seg Unit offers a variety of meditation, classical and contemporary music, “how to” and instructional-type material on their headphones. All prisoners stay in their regular orange or green jumpsuits.

While the conversation about solitary is crucial, there has to be a better way than anti-suicide smocks to keep prisoners safe and correction officers from the trauma of finding a hanged prisoner. Instead of settling for “the new straight jacket,” I’m depending on my students to come up with a solution.